Prevalence and genetic characteristics of Saffold cardiovirus in China from 2009 to 2012

Zhang, Xiao-Ai; Lu, Qing-Bin; Wo, Ying; Zhao, Jin; Huang, Dou-Dou; Guo, Chen-Tao; Xu, Hong-Mei; Liu, En-Mei; Liu, Wei; Cao, Wu-Chun

Patient recruitment and sample collection. Three cohorts of pediatric patients were recruited from March 2009 to December 2012 in Chongqing Children's Hospital, Chongqing, China. Cohort 1 comprised hospitalized patients with acute respiratory tract infection (ARTI), which was determined based on cough, rhinorrhea, dyspnea, and/or acute fever.37.5uC. For recruited patients, nasopharyngeal aspirates (NPA) samples were collected upon hospital admission. Cohort 2 comprised outpatients with diarrhea, who had. 3 loose stools in the previous 24 hours. Patients who had confirmed inflammatory bowel disease, celiac disease, cystic fibrosis, food intolerance, or patients who had any apparent clinical respiratory signs or symptoms were excluded. Stool samples were collected from the recruited patients. Cohort 3 consisted of patients who were diagnosed with hand, foot, and mouth disease (HFMD), according to the guidelines released by the Ministry of Health of the People's Republic of China (http://www.moh.gov.cn/publicfiles/business/htmlfiles/ mohyzs/s3586/201004/46884.htm). The outpatients were generally mild, with fever, and manifested at least one of the following features: maculopapular or vesicular rash on the palms, and/or soles, vesicles or ulcers in the mouth. Hospitalized patients were diagnosed with severe HFMD if they manifested one of the following additional complications: encephalitis, meningitis, AFP, or cardiorespiratory failure. For all HFMD patients, stool samples were collected, whereas for some cases, stool, throat swab, and serum samples were collected. In addition, CSF was additionally collected for some cases diagnosed with encephalitis. Healthy children who were recruited from the community during the same study period were used as controls, from whom stool, throat swab, and serum samples were also collected. None of the recruited healthy children exhibited ARTI, diarrhea, or HFMD-related symptoms during the recent one month of recruit.